301.03 How to Determine Residency for Medical Assistance SR 13-36, 11/13 (MAM-A)

When determining state of residence for Medicaid-only individuals, consider variables such as institutional status, age, and ability to express intent. When two or more states cannot resolve which is the state of residence, the state where the individual is physically located is the state of residence for Medicaid purposes. Use the following chart to determine residency for medical assistance only cases.

 

If the individual is...

the state of residency is...

Noninstitutionalized (any age),

• the state the individual is living in, with the intent to remain permanently or for an indefinite period.

Institutionalized, age 21 or over,

• capable of indicating intent,

 

• the state where the individual is living with the intention to remain permanently or for an indefinite period.

• became incapable of indicating intent at or after age 21,

 

• the state in which the individual physically resides.

 Exception: If another state placed the individual, the state of residence remains with the placing state.

• became incapable of indicating intent before age 21,

• the parent or legal guardian’s state of residence at the time of placement.

- If there are two parents living in different states, use the state of residence of the parent filing the application for assistance.

- If a legal guardian has been appointed and parental rights terminated, use the legal guardian’s state of residence.

- If there is both a legal guardian of the person and a financial guardian, use the legal guardian of the person to establish residency.

• the state where the person who files the application resides, if the individual has been abandoned, the child’s parent has died, or someone other than a parent or guardian has placed the child..

Institutionalized, under age 21:

• Emancipated, or married and capable of indicating intent,

 

• the state in which the individual physically resides.

• Incapable of indicating intent,

• the parent or legal guardian’s state of residence at the time of placement.

- If there are two parents living in different states, use the state of residence of the parent filing the application for assistance.

- If a legal guardian has been appointed and parental rights terminated, use the legal guardian’s state of residence.

- If there is both a legal guardian for the child and a financial guardian, use the legal guardian’s state of residence to establish residency.

• the state where the person who filed the application resides, if the child has been abandoned, the child’s parent has died, or someone other than a parent or guardian has placed the child.

References: He-W 630.01, RSA 169-C:3,XIV, 42 CFR 435.403